Short Health Anxiety Inventory - (SHAI)
Table of Contents
Introduction – Understanding Health Anxiety & the SHAI
Short Health Anxiety Inventory (SHAI) – A Tool for Measuring Health Anxiety
Do you frequently worry about your health, even when medical tests find nothing wrong? Do you find yourself checking your body for signs of illness or seeking reassurance from doctors, family, or online searches? If so, these could be signs of health anxiety, a condition that can significantly impact daily life.
The Short Health Anxiety Inventory (SHAI) is a scientifically validated self-assessment designed to measure the severity of health-related anxiety. Whether you’re experiencing mild, moderate, or severe health anxiety, this test provides a structured way to assess your level of concern.
👉 Use this self-assessment to better understand your health-related worries and see if they might be excessive.
What is Health Anxiety?
Health anxiety involves persistent and excessive fears about having or developing a serious illness, even when medical reassurance has been given. It is sometimes referred to as Illness Anxiety Disorder in the DSM-5, which classifies it as a condition where a person misinterprets normal bodily sensations as signs of serious illness.
The DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5th Edition) is like a guidebook used by psychologists and doctors to understand and diagnose mental health conditions. Think of it as a rulebook that helps professionals decide when someone’s thoughts, emotions, or behaviors might indicate a mental health disorder rather than just everyday stress or worry.
Why is the DSM-5 Important?
It provides standardized definitions for mental health conditions, meaning professionals around the world can use the same criteria when diagnosing and treating people. This helps ensure that two different therapists would recognize the same symptoms in the same way.
How Does It Relate to Health Anxiety?
In the DSM-5, health anxiety is classified as “Illness Anxiety Disorder.” This means someone might be excessively worried about having or developing a serious illness, even when medical tests show no real health issues. The SHAI (Short Health Anxiety Inventory) aligns with the DSM-5 by helping measure the severity of these health-related fears.
👉 Simply put, the DSM-5 is a handbook that helps mental health professionals diagnose conditions like health anxiety and provide the right treatment.
🩺 Common Symptoms of Health Anxiety Include:
✔️ Constantly checking the body for signs of illness
✔️ Excessive Googling of health symptoms (“cyberchondria”)
✔️ Repeatedly seeking medical tests or reassurance from doctors
✔️ Difficulty accepting medical reassurances
✔️ Avoiding hospitals, medical TV shows, or news about illnesses
✔️ Experiencing high anxiety or panic when reading about diseases
Is Health Anxiety the Same as General Anxiety?
While general anxiety may involve worrying about a range of topics (e.g., finances, relationships), health anxiety is specifically focused on concerns about personal health. Some people with health anxiety constantly check their symptoms, while others avoid medical information altogether, fearing what they might find.
About the SHAI – What It Measures
The Short Health Anxiety Inventory (SHAI) is a scientifically validated tool designed to measure the severity of health anxiety. Developed by Paul Salkovskis and colleagues (2002), it is widely used by clinicians and researchers to assess health-related fears and their impact on daily life.
What the SHAI Measures:
The SHAI evaluates two key aspects of health anxiety:
1️⃣ Illness Likelihood (Health Anxiety) – 14 Items
- Measures how often a person worries about having an illness, misinterprets bodily symptoms, and struggles with reassurance.
2️⃣ Negative Consequences of Illness – 4 Items
- Assesses how catastrophic a person perceives the consequences of illness (e.g., “If I had a serious illness, it would ruin my life”).
How the SHAI is Structured
The SHAI consists of 18 multiple-choice questions, each rated from 0 to 3 based on how much a statement applies to you:
| Response Options | Scoring |
|---|---|
| “Not at all” | 0 |
| “A little” | 1 |
| “Moderately” | 2 |
| “A lot” | 3 |
Total SHAI Scores Range from 0–54
- Higher scores indicate greater health anxiety.
How to Interpret Your Score
SHAI Score Interpretation:
- 0–15: Low or mild health anxiety (normal level of concern)
- 16–30: Moderate health anxiety (some distress, may cause worry)
- 31–40: High health anxiety (frequent worry, possible Illness Anxiety Disorder)
- 41–54: Severe health anxiety (significant distress, likely Illness Anxiety Disorder)
How the SHAI is Used in Clinical Practice
Doctors, psychologists, and mental health professionals use the SHAI to:
✔️ Screen for health anxiety (Illness Anxiety Disorder)
✔️ Track progress during therapy
✔️ Differentiate health anxiety from actual medical concerns
✔️ Develop treatment plans for cognitive-behavioral therapy (CBT)
Why is the SHAI Helpful?
The SHAI is brief, easy to complete, and clinically reliable, making it an excellent tool for measuring changes in health anxiety over time.
Take the SHAI Test Below
Take the Short Health Anxiety Inventory (SHAI) now to assess your level of health anxiety.
⚠️ Remember, this test is for informational purposes only and does not replace a professional diagnosis.
Instructions
Each of the following questions consists of a group of four statements. Please read each group of statements carefully and then select the one which best describes how you have felt over the past six months. If you find that more than one statement applies, please select any of the applicable statements.
Frequently Asked Questions About the SHAI
Is the SHAI a diagnostic tool?
No. The SHAI measures health anxiety severity, but a diagnosis requires a professional evaluation.
What if my SHAI score is high?
A high score suggests significant health anxiety, but it does not confirm a medical condition. Seeking guidance from a mental health professional may help.
Can the SHAI track improvements in therapy?
Yes. Many therapists use the SHAI to track progress and measure treatment effectiveness over time.
Is the SHAI free to use?
Yes! The SHAI is in the public domain and can be freely used by clinicians and researchers.
Explore More Anxiety Self-Assessments
✔ GAD-7 Anxiety Test – Generalized Anxiety Disorder Screening
✔ PDSS Panic Disorder Test – Panic Disorder Severity Scale
✔ SPIN Social Anxiety Test – Social Phobia Inventory
✔ OCI-R OCD Test – Obsessive-Compulsive Inventory
✔ SMSP-A Phobia Test – Severity Measure for Specific Phobia – Adult
✔ SHAI Health Anxiety Test – Short Health Anxiety Inventory
✔ PSWQ Anxiety Test – Penn State Worry Questionnaire
References
Salkovskis, P. M., Rimes, K. A., Warwick, H. M. C., & Clark, D. M. (2002). The Health Anxiety Inventory: Development and validation of scales for the measurement of health anxiety and hypochondriasis. Psychological Medicine, 32(5), 843–853. https://doi.org/10.1017/S0033291702005822
This seminal paper introduced the Health Anxiety Inventory (HAI) and its short version (SHAI). It details the scale’s construction, initial validation, and ability to differentiate hypochondriasis from other disorders. It also confirms the SHAI’s strong psychometric properties, including sensitivity to treatment-related changes.
Warwick, H. M. C., & Salkovskis, P. M. (1990). Hypochondriasis. Behaviour Research and Therapy, 28(2), 105–117. https://doi.org/10.1016/0005-7967(90)90023-C
This foundational paper outlines the cognitive-behavioral model of health anxiety, explaining how misinterpretations of bodily sensations contribute to persistent health fears. This model directly influenced the SHAI’s item development.
Alberts, N. M., Hadjistavropoulos, H. D., Jones, S. L., & Sharpe, D. (2013). The Short Health Anxiety Inventory: A systematic review and meta-analysis. Journal of Anxiety Disorders, 27(1), 68–78. https://doi.org/10.1016/j.janxdis.2012.10.009
A systematic review of 42 studies assessing the SHAI’s reliability and validity. The review concludes that the SHAI has excellent psychometric properties and remains a gold-standard tool for assessing health anxiety across various settings.
Abramowitz, J. S., Deacon, B. J., & Valentiner, D. P. (2007). The Short Health Anxiety Inventory in a non-clinical sample: Investigating factor structure and psychometric properties. Psychological Assessment, 19(2), 268–275. https://doi.org/10.1037/1040-3590.19.2.268
This study explores the factor structure of the SHAI, confirming its two-factor model: one measuring illness likelihood and the other assessing the perceived severity of illness consequences. It supports the SHAI’s use in both clinical and general populations.
Wheaton, M. G., Berman, N. C., Fabricant, L. E., & Abramowitz, J. S. (2010). Psychometric properties of the Illness Anxiety Scale and comparison of the factor structure of health anxiety measures. Psychological Assessment, 22(3), 539–552. https://doi.org/10.1037/a0019169
A comparison of the SHAI with other health anxiety measures, including the Whiteley Index and the Illness Attitude Scales. This paper evaluates different factor structures and recommends a refined two-factor model for the SHAI.
Hedman, E., Ljótsson, B., Andersson, E., Andersson, G., & Ruck, C. (2015). Optimal cut-off points on the Health Anxiety Inventory, Illness Attitude Scales, and Whiteley Index to identify severe health anxiety. PLoS ONE, 10(4), e0123412. https://doi.org/10.1371/journal.pone.0123412
This study investigates optimal cutoff scores for identifying severe health anxiety using the SHAI and related measures. It provides empirical guidance on interpreting SHAI scores in clinical practice.
Hedman, E., Ljótsson, B., et al. (2015). Psychometric properties of internet-administered measures of health anxiety: An investigation of the HAI, IAS, and WI. Journal of Anxiety Disorders, 31, 32–37. https://doi.org/10.1016/j.janxdis.2015.02.002
This study confirms that the SHAI maintains its reliability and validity when administered online, making it suitable for telehealth assessments.
Österman, S., et al. (2022). The 14-item Short Health Anxiety Inventory (SHAI-14) used as a screening tool: Appropriate interpretation and diagnostic accuracy of the Swedish version. BMC Psychology, 10(1), 244. https://doi.org/10.1186/s40359-022-00843-2
A recent study evaluating the SHAI-14, a shortened version of the SHAI for rapid screening. It provides guidance on interpreting scores in different healthcare settings, including primary care and psychiatric clinics.
Belli, A., et al. (2020). The Spanish validation of the Short Health Anxiety Inventory: Psychometric properties and clinical utility. International Journal of Clinical and Health Psychology, 20(1), 40–47. https://doi.org/10.1016/j.ijchp.2019.11.002
A validation study confirming the SHAI’s reliability and validity in a Spanish sample. The study establishes a cutoff score of ~40 as optimal for distinguishing severe health anxiety cases from normal health concerns.
